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2021-01-19Zeitschriftenartikel
Barriers to using HIV pre-exposure prophylaxis (PrEP) and sexual behaviour after stopping PrEP: a cross-sectional study in Germany
dc.contributor.authorKoppe, Uwe
dc.contributor.authorMarcus, Ulrich
dc.contributor.authorAlbrecht, Stefan
dc.contributor.authorJansen, Klaus
dc.contributor.authorJessen, Heiko
dc.contributor.authorGunsenheimer-Bartmeyer, Barbara
dc.contributor.authorBremer, Viviane
dc.date.accessioned2022-02-01T14:48:32Z
dc.date.available2022-02-01T14:48:32Z
dc.date.issued2021-01-19none
dc.identifier.other10.1186/s12889-021-10174-4
dc.identifier.urihttp://edoc.rki.de/176904/9323
dc.description.abstractBackground Persistence of individuals at risk of HIV with Pre-Exposure Prophylaxis (PrEP) is critical for its impact on the HIV epidemic. We analysed factors associated with stopping PrEP, barriers that may deter people from continuing PrEP and investigated sexual behaviour after stopping PrEP. Methods Current and former PrEP users in Germany were recruited to complete an anonymous online survey on PrEP use and sexual behaviour. Participants were recruited through dating apps, a PrEP community website, anonymous testing sites and peers. The results were analysed using descriptive methods and logistic regression. Results We recruited 4848 current and 609 former PrEP users in two study waves (July–October 2018, April–June 2019). Former PrEP users were more likely 18–29 years old than current users (adjusted OR = 1.6, 95% confidence interval (CI) 1.1–2.3). Moreover, they were more often unhappy with their sex life, which was more pronounced in former daily PrEP users (aOR = 4.5, 95% CI 2.9–7.1) compared to former on-demand users (aOR = 1.8, 95% CI 1.1–2.9, pinteraction = 0.005). The most common reason for stopping PrEP was a reduced need for PrEP (49.1%). However, 31.4% of former users identified logistic reasons and 17.5% stopped due to side effects. Former PrEP users using PrEP < 3 months were more likely to stop PrEP due to concerns over long-term side effects (32.0% vs. 22.5%, p = 0.015) and not wanting to take a chemical substance (33.2% vs. 24.0%, p = 0.020) compared to former PrEP users who used PrEP for longer. After stopping PrEP, 18.7% of former PrEP users indicated inconsistent condom use while having ≥4 sex partners within the previous 6 months. Former PrEP users with many partners and inconsistent condom use more often indicated logistic reasons for stopping (46.5% vs. 27.9%, p < 0.001) than did other former PrEP users. Conclusions To maximise persistence with PrEP we need to develop strategies for younger PrEP users, reduce logistic barriers to access PrEP, and to develop effective communication on side-effect management. Moreover, prevention strategies for people stopping PrEP are required, since some remain at high risk for HIV.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectHIV pre-exposure prophylaxiseng
dc.subjectMen, Who have sex with meneng
dc.subjectFormer useeng
dc.subjectCondom useeng
dc.subjectSide effectseng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleBarriers to using HIV pre-exposure prophylaxis (PrEP) and sexual behaviour after stopping PrEP: a cross-sectional study in Germanynone
dc.typearticle
dc.identifier.urnurn:nbn:de:0257-176904/9323-0
dc.type.versionpublishedVersionnone
local.edoc.container-titleBMC Public Healthnone
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10174-4none
local.edoc.container-publisher-nameSpringer Naturenone
local.edoc.container-volume21none
local.edoc.container-year2021none
local.edoc.container-firstpage1none
local.edoc.container-lastpage10none
local.edoc.rki-departmentInfektionsepidemiologienone
dc.description.versionPeer Reviewednone

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